Pregnancy can be tough both mentally and physically. Not only is your body changing in a million different ways, but every little twinge can make you panic that something is wrong. Relax, say the experts. “Women need to remind themselves that the vast majority of pregnancies go smoothly,” says Bruce Flamm, M.D., an OB-GYN in Riverside, California.
Still, pregnancy complications can happen on rare occasions. That’s why it’s important for every expecting mom to know about warning signs. The following symptoms require an immediate phone call to your doctor. (But keep in mind that these are only guidelines; you should call your provider anytime you have questions or concerns specific to your pregnancy.)
Biggest concern between 4 and 20 weeks of pregnancy
Most of the time, morning sickness is an annoying yet normal symptom of pregnancy. But if you’re throwing up so much that you can’t keep liquids down or you’re not urinating, you need to let the doctor know right away. “This can lead to severe dehydration, which isn’t good for you or your baby,” says Isabel Blumberg, M.D., an OB-GYN in New York City. Extreme vomiting can also be a sign that you’re suffering from hyperemesis gravidarum, a type of extreme morning sickness that can last throughout your entire pregnancy.
Also call the doctor if you haven’t been able to keep food down for two days straight, if you think you have food poisoning, or if the vomiting is accompanied by a high fever. In these cases, you may need to go to the hospital for IV fluids.
Concern throughout pregnancy
Vaginal bleeding, especially in the first trimester, is fairly common. In fact, approximately 25 percent of women experience some spotting or heavier bleeding in the first 13 or so weeks; of those, more than half go on to have perfectly healthy babies.
Bleeding in the first trimester may be a sign of miscarriage, especially if it’s accompanied by cramping. But another common cause is implantation of the egg in the lining of the uterus, says Daniel Landers, M.D., a maternal-fetal medicine specialist at the University of Minnesota, Twin Cities. Benign cervical polyps, which are fairly common whether you’re pregnant or not, may also be to blame. Another potential cause is cervical bleeding, which can occur after intercourse in pregnant women with tender tissues.
Bleeding during pregnancy is probably more worrisome in the second or third trimesters It might occur when the mucus plug that seals the cervix is lost in early labor. Or “it could mean that you have a tear in your placenta or another problem that should be diagnosed by ultrasound,” says Dr. Flamm. If you notice bleeding anytime during pregnancy, it’s smart to call your doctor immediately.
Biggest concern after 20 weeks of pregnancy
If you get occasional headaches while expecting, it’s probably no big deal. If you find you’re suffering from a severe and persistent headache—especially if it is accompanied by fainting, dizziness, and/or blurred vision—you should call your doctor. Find a comfortable spot to sit down if you’re feeling faint, and have someone sit with you while you chat on the phone or wait for your doctor to return your call. Try drinking a bit of water (dehydration is often the cause of these symptoms) and lying on your left side.
Severe headaches in the second and third trimester might signal preeclampsia, a condition characterized by high blood pressure. This condition reduces blood flow to the baby and can cause health problems for Mom. Women at greatest risk are those with a family or personal history of preeclampsia, high blood pressure, or preexisting diabetes; or women who are obese or carrying more than one baby.
Aside from recurring or unremitting headaches, other symptoms of preeclampsia include:
- Excessive swelling of feet, hands, or face
- Abdominal pain, particularly on the right side
- Rapid weight gain (i.e, 10 pounds in 4 days)
- Blurred vision; seeing light flashes or spots
- Flu-like achiness without the usual runny nose or sore throat
Intense abdominal pain
Biggest concern in the first 12 weeks and the last few weeks of pregnancy
If you’re less than 12 weeks pregnant, you’re doubled over with sharp cramps on one side of your stomach, and you’ve yet to have an ultrasound, your doctor will want to rule out an ectopic pregnancy (one in which the egg has implanted itself in the fallopian tube rather than in the uterus).
Abdominal pain in late pregnancy is usually normal. “Unless the pain is getting worse, unrelenting, or is associated with bleeding, it is likely just normal uterus growing, round ligaments stretching, or gas,” explains Laura Riley, M.D., director of Labor and Delivery, and Obstetrics at Massachusetts General Hospital. But see the doctor for intense or recurrent pain later in the pregnancy, since it could be anything from contractions to appendicitis.
- RELATED: Abdominal Pain During Pregnancy
Chills or High Fever
Biggest concern in the first few weeks of pregnancy
Running a fever is never fun, but during pregnancy, it can pose an additional health hazard to your baby. Your little one’s growth and development depends on your body maintaining a steady and healthy temperature (around 98.6 degrees to 103 degrees Fahrenheit). Early in pregnancy, disruption of this temperature can wreak havoc on your system and lead to a miscarriage. Later in your pregnancy, a higher temperature won’t affect your baby too much, but it may be a sign of infection or another issue that your doctor should know about.
Lots of watery discharge
Biggest concern between 24 to 36 weeks of pregnancy
If you’re near the end of your pregnancy, a discharge probably means your water has broken. But if you suddenly experience a gush of fluids anytime before 37 weeks, call your doctor pronto. It might be a sign that your amniotic sac has ruptured and you’re going into preterm labor. But don’t assume the worse as you head the hospital: “Women immediately think that their water has broken too early, when in reality the baby may have just kicked them hard in the bladder and they lost some urine,” says Dr. Flamm.
Biggest concern between 24 and 36 weeks of pregnancy
Contractions are another potential sign of preterm labor. So if you suddenly feel them when you’re 24 to 36 weeks pregnant, pick up the phone. While they could just be harmless Braxton Hicks contractions, talk to your doctor to make sure.
Biggest concern between 6 and 24 weeks of pregnancy
Although frequent urination is a common complaint during pregnancy, burning and pain upon emptying your bladder is not. This symptom is the telltale sign of a bladder infection or a urinary tract infection (UTI)—a common occurrence for many women, and especially uncomfortable during pregnancy. Treating these symptoms to help prevent complications (which can include preterm labor and low birth weight babies). Left untreated over several days or weeks, a UTI can lead to a kidney infection, which has been linked to preterm labor. So while you don’t need to see a doctor ASAP, make sure to schedule a visit soon.
Biggest concern in the third trimester
Are you itching all over your body, especially your hands and feet? While mild itching is common, severe itchiness could point to cholestasis of pregnancy. This is a liver ailment that should be monitored by a doctor. While it is often harmless and treated with topical anti-itch medications, it can lead to preterm birth in extreme cases.
Lack of fetal movement
Biggest concern in the third trimester
Later in pregnancy, you’ll begin to track your baby’s movements by doing fetal kick counts. Most doctors recommend checking in with your growing baby a few times a day and looking for 10 movements within 10 minutes. If you try a count and don’t feel any movement, drink a glass of fruit juice (the natural sugars boost baby’s blood sugar and can get her moving), then lie on your left side in a quiet room for half an hour. If after a second try you don’t feel any movement—or if two hours pass without 10 movements—be sure to ring your health care practitioner. “Usually it’s nothing and the baby was just being especially still,” says Dr. Blumberg. “But your doctor will probably want you to have a stress test or an ultrasound to make sure there aren’t any problems.”
- RELATED: What Does a Baby Kick Feel Like?
A long lull could signal oligohydramnios, or low amniotic fluid, says Donna Dizon-Townson, M.D., assistant professor of obstetrics and gynecology at the University of Utah in Salt Lake City. Low amniotic fluid affects some 10 percent of pregnancies. Often, the mother is simply dehydrated, and drinking plenty of water will resolve the problem, says Dr. Dizon-Townson. Oligohydramnios may also be caused by a rupture in the amniotic sac, the placenta’s failure to work properly, or rarely, a defect involving the baby’s kidneys or bladder (amniotic fluid is actually baby’s urine). In such cases, bed rest can minimize fluid loss and prolong your pregnancy.
However, if you’re experiencing this problem after the 38th week of pregnancy, your doctor may induce delivery to avoid the danger of the cord getting compressed, cutting off blood flow to the baby. Amniotic fluid serves as a cushion for the umbilical cord, preventing baby from crimping or crushing his own lifeline
A Pain in the Leg
Concern throughout the pregnancy
Pregnancy puts a woman at six times greater risk for blood clots in the deep veins of the legs, called deep vein thrombosis (DVT). Hormonal changes make your blood more likely to clot, says Dr. Dizon-Townson, while the pressure of the growing uterus on your veins can impede circulation, causing blood to pool in your legs and feet.
DVT might be difficult to distinguish from the ordinary leg cramps of pregnancy. But dependable red flags are that the symptoms occur in just one leg and the area is red, painfully swollen, and warm to the touch.
Unfortunately, DVT can also be silent. In such cases, the first “symptom” may be pulmonary embolism, when a piece of the clot breaks away and travels to the lung. If you experience shortness of breath, chest pain, or a rapid heart rate, call your doctor or 911.
Women who are older, overweight, or genetically predisposed to clotting are at higher risk for DVT, as are those put on bed rest. If you’re ordered off your feet for another pregnancy complication, your doctor may recommend you take heparin or wear special compression stockings to promote circulation, says Dr. Dizon-Townson.
For women who are otherwise healthy, staying active and well-hydrated may help to prevent clots, she adds. It’s also important to get on your feet in the hours and days after delivery, when DVT risk remains high.
- RELATED: 14 Very Early Pregnancy Symptoms
5 Symptoms Not to Worry About
Definitely mention these five symptoms to your health care provider when she asks how you’ve been—she should know what’s going on, even if it’s no big deal—but there’s no need to waste your time worrying about them.
It takes a lot of work to grow a baby, and many women find themselves sleeping more and exercising less. Energy levels wax and wane during pregnancy and it is important for expectant mothers to listen to their bodies and rest when they feel the need. Alice Domar, Ph.D., assistant professor of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School, tells patients that they do not need to feel like they must do everything during pregnancy. Skip making dinner. Let the laundry sit unfolded once in a while. After a long day of work, “it’s okay to order a pizza and watch reruns” to rest and recharge, Dr. Domar says.
2. Vivid Dreams or Nightmares
“It is completely normal to have extremely vivid, even scary nightmares or dreams because of the pregnancy,” Dr. Domar says. Many pregnant women report an increase in random, lifelike dreams. “Hormones make it hard to differentiate in the middle of the night between reality and nightmares,” Dr. Domar says. “While these dreams seem to heighten in the third trimester, they are normal and typically subside once pregnancy is over.”
The baby pressing down on a woman’s rectum and the slowing down of intestinal muscles due to pregnancy hormones make constipation a common complaint during pregnancy. The iron in prenatal vitamins or iron supplements for anemia (another side effect of pregnancy) also cause constipation. There is no need to immediately worry, as most women find relief by increasing their fiber intake, drinking more fluids, and exercising. Some over-the-counter stool softeners are helpful and safe to try, and can alleviate constipation as well.
- RELATED: How to Manage Pregnancy Constipation
4. Confusion or Forgetfulness
“Pregnancy brain does exist,” Dr. Domar says. “Women are more forgetful, especially in the third trimester.” Although it is frustrating to forget words, appointments, or tasks at times, it is part of the pregnancy package. An expectant mom may feel like she’s going crazy, but the stress of pregnancy and a future new baby can affect memory.
5. Mood Swings
Women experience changes in their sleep patterns and eating habits during pregnancy, and these affect a woman’s emotional state. Dr. Domar explains that it is completely common to feel “scared, irritable, or ambivalent” when pregnant. It is not talked about as often, but pregnancy is an extremely emotional experience and there is a lot going on in a woman’s head during those nine months. Sometimes a pregnant woman’s feelings change hourly and move quickly from happy to sad to nervous. “Women have a lot of insecurity over whether they’re going to be a good mother,” Dr. Domar explains. The most important thing is to realize that these questions and fears are a normal part of pregnancy, but definitely get help if you feel as though something is seriously wrong, or if you have thoughts of hurting yourself or someone else.